July, 2008:

Decades after the surgeon general first warned that cigarettes were a health hazard, the House of Representatives overwhelmingly approved legislation on Wednesday that would for the first time give the Food and Drug Administration the power to regulate tobacco products.

Citing the long history of warnings about the dangers of smoking, Representative John D. Dingell, chairman of the Energy and Commerce Committee, said that it was hard to believe that the federal government had not yet regulated the tobacco industry.

“With this legislation, we change this,” said Mr. Dingell, a Michigan Democrat.

The White House has signaled its opposition to the bill. And while the legislation has strong support in the Senate, which could take up the measure this fall, it is not clear whether the bill has a veto-proof majority there.

The show of support in the House, which passed the bill by a vote of 326 to 102, illustrated not only the strength of antismoking sentiment in the country but the benefit of enlisting a powerful ally. The legislation was partly the result of negotiations with Philip Morris USA, the nation’s largest cigarette company, which split with other companies by endorsing it.

Most large public health groups supported the measure — and its passage was applauded by groups including the American Lung Association and the American Heart Association — but some antismoking advocates said the bargain struck with Philip Morris gave too many concessions to the industry.

The bill specifically states that the F.D.A.’s new powers would stop short of the ability to order the elimination of nicotine from tobacco products or place an outright ban on all tobacco products.

But the agency could reduce nicotine to nonaddictive levels if it determined that doing so would benefit public health. The F.D.A. could also require changes in tobacco products, like the reduction or elimination of other harmful ingredients.

The bill bans flavored cigarettes that appeal to young people but exempts menthol from that ban. The exemption raised objections from black antismoking advocates because mentholated cigarettes are frequently chosen by black smokers.

To satisfy the Congressional Black Caucus on that issue, last-minute changes were made in the bill to direct a scientific advisory committee to issue recommendations on menthol in cigarettes within one year.

In a statement, Lorillard Tobacco Company, whose Newport cigarettes are the leading menthol brand, said it opposed the bill but “welcomes the provision in this bill that calls for a scientific review of menthol in cigarettes.”

Lorillard said that scientific studies to date do not support a conclusion that menthol cigarettes are more hazardous or addictive than non-menthol cigarettes.

The amendments also require the F.D.A. to publish an action plan on the advertising and promotion of menthol and other cigarettes to young people, giving priority to minority communities.

The bill was opposed by many Republicans. Many said they objected to expansion of the federal bureaucracy, and complained in particular that the F.D.A. was already unable to fulfill its work overseeing pharmaceuticals and food.

In floor discussion, John A. Boehner, the House minority leader, a smoker, called the legislation a “boneheaded idea.”

“How much is enough?” Mr. Boehner said. “How much government do we need? There’s not a smoker in America that doesn’t understand that smoking isn’t good for you.”

But Henry A. Waxman, the California Democrat who sponsored the bill, responded, “The minority leader said ‘When is enough, enough?’ Well cigarettes, one of the most dangerous products on sale today, are not regulated at all.”

The legislation would finance the F.D.A.’s tobacco supervision primarily through new fees paid by tobacco companies that are earmarked for that purpose.

If the legislation is enacted, consumers would see a wholesale revamping of the warning labels on tobacco products. The small messages currently on cigarette packs warning of the negative health effects would be replaced by graphic images of the physical ravages often caused by cigarettes, such as lung tumors and mouth growths.

The bill will also require cigarette makers to provide detailed disclosure about the type and quantities of ingredients in their products — like ammonia and acetaldehyde — which are believed to work with nicotine to increase the addictiveness of cigarettes and smokeless tobacco. The requirements mean that companies would be required to disclose internal research on the biological effects of those additives.

Cigarette companies could no longer advertise their products as “light” or “ultralight” to convey the notion of less harmful ingredients. Some companies have anticipated those changes by packaging their products so that cigarettes packs are color-coded to denote different blends.

Under the bill, any outdoor advertising of cigarettes, and advertising in publications seen by children, would have to be in black and white, to reduce their visual allure.

House approval of the bill follows years of debate over whether tobacco products should be regulated.

While attempts to place tobacco products under the agency’s jurisdiction date back at least to the 1980s, the impetus for the current bill originates in 1995, when Dr. David A. Kessler, then F.D.A. commissioner, proposed a set of regulations governing tobacco. Dr. Kessler asserted that nicotine was an addictive drug and that tobacco companies deliberately manipulated the nicotine content of their products.

Dr. Kessler had tried to impose regulations on the industry but the Supreme Court overturned them in 2000.

A bill that would have placed tobacco under F.D.A. jurisdiction was passed by the Senate in 2004 but was never approved by the House. The bill that the House approved Wednesday was introduced in both chambers in 2007.

Alicia Keys has apologised to fans in Indonesia after discovering one of her forthcoming concerts was sponsored by tobacco firm Philip Morris.

Billboard posters for tomorrow night’s Jakarta gig featured a logo for the A Mild cigarette brand, BBCi reported.

In a statement, Keys (pictured) said she asked for “corrective actions” as soon as she learned of the advertisements. As a result, she added, the company had withdrawn its sponsorship and all signage had been removed.

The Grammy award-winning singer had been criticised by anti-smoking campaigners, who claimed the deal would encourage young fans to take up smoking.

Campaigning organisation Tobacco Free Kids said the branding was “inconsistent with [Keys’] advocacy for children’s health through her involvement in Keep A Child Alive, a campaign to address the HIV/Aids epidemic in poor countries”.

It sent an open letter to the R&B star, signed by several anti-tobacco agencies, calling on her to “put the health of Indonesia’s children first” and remove the advertising or cancel her concert.

In her statement, Keys said: “I apologise for any misleading advertising initially associated with the show. I’m an unyielding advocate for the well-being and health of children around the world and do not condone or endorse smoking.

“I look forward to bringing my music and message to my wonderful fans in Jakarta.”

The U.S. House of Representatives today cast a truly historic vote to protect children from tobacco addiction and save lives by overwhelmingly approving legislation granting the U.S. Food and Drug Administration authority to regulate tobacco products. This is the first time the House has ever approved such legislation. Today’s vote by a clear veto-proof margin of 326 to 102 underscores the broad, bipartisan support for this legislation and provides powerful momentum for enacting it into law this year.

The House vote is a giant step toward ending the special protection the tobacco industry has enjoyed for too long and at such great cost to the nation’s health. Now the Senate should seize this unprecedented opportunity to protect the nation’s health and approve this legislation when it returns in September. With 57 sponsors and several other senators who have committed to supporting the bill, the Senate has the votes to pass this legislation this year. It is disappointing that some of the President’s advisors have said they would recommend a veto of the bill. We urge the President to support this historic effort to protect our children and address the leading cause of preventable death in the United States.

We applaud the bill’s sponsors, U.S. Reps. Henry Waxman and Tom Davis, Energy and Commerce Committee Chairman John Dingell and Health Subcommittee Chairman Frank Pallone for their leadership in moving this legislation forward. We are eager to continue working with them and the Senate sponsors, Senators Edward Kennedy and John Cornyn, to enact this legislation into law.

This legislation has strong support across the nation. It has been endorsed by more than 680 public health, medical, faith and other organizations (see list at http://www.tobaccofreekids.org/reports/fda/organizations.pdf. It is supported by 70 percent of American voters, with support across political lines, geographic regions and even by a majority of smokers, according to a poll conducted in May 2008 (detailed poll results: http://tobaccofreekids.org/fdapoll/). Last year, both the Institute of Medicine of the National Academies of Sciences and the President’s Cancer Panel issued landmark reports endorsing FDA regulation of tobacco products.

This legislation is urgently needed. Tobacco use kills more than 400,000 Americans and costs the nation nearly $100 billion in health care bills each year. Every day, another 1,200 Americans die from tobacco use and more than 1,000 children become new regular smokers. Yet tobacco products are virtually unregulated to protect public health. This lack of regulation allows tobacco companies to market their deadly and addictive products to children, deceive consumers about the harm their products cause, make changes to their products without disclosing them (such as manipulating nicotine and menthol levels in cigarettes), and resist any meaningful change to make their products less harmful.

This legislation would grant the FDA strong and effective authority over the manufacturing, marketing and sale of tobacco products. It would:

Impose specific restrictions on tobacco marketing and sales to kids. Among other things, it would limit tobacco advertising in publications with significant teen readership and outdoor and point-of-sale advertising to black-and-white text only and provide for enforcement and penalties against retailers who sell tobacco products to minors.

Grant the FDA authority to further restrict tobacco marketing to the full extent allowed by the First Amendment to the Constitution.

Require tobacco companies to disclose the contents of tobacco products, changes to their products and research about the health effects of their products.

Grant the FDA broad authority to require changes in tobacco products, such as the reduction or removal of harmful ingredients and the reduction of nicotine to non-addictive levels. This includes the authority to reduce or eliminate menthol in cigarettes.

Ban candy-flavored cigarettes.

Require larger, more effective health warnings on tobacco products and advertising. Health warnings would have to cover 30 percent of the front and rear panels of tobacco packages, and the FDA could require graphic warnings that cover 50 percent of the front and rear panels.

Prohibit health claims about so-called “reduced risk” products that are not scientifically proven or that would discourage current tobacco users from quitting or encourage new users to start.

Prohibit misleading terms such as “low-tar,” “light” and “mild.”

The FDA is the right agency to regulate tobacco products because it is the only agency with the combination of regulatory experience, scientific expertise and public health mandate. The pending legislation is carefully crafted to ensure the FDA’s new tobacco-related responsibilities do not in any way impede or take resources from its current responsibilities. The legislation would require tobacco companies to pay user fees that would fully fund the FDA’s tobacco-related responsibilities so no funding is taken from the FDA’s current work. The legislation would also create a new, separate center for tobacco product regulation within the FDA, leaving existing offices and functions within FDA undisturbed by this new authority.

We urge Congress to enact this life-saving legislation into law this year. There are few steps Congress can take that would make a bigger difference for our nation’s health.

Escambia County will have a tobacco-free hiring policy starting in October.

All applicants for county jobs are currently required to take a drug test, which will be expanded to include testing for tobacco use. Any applicant testing positive for tobacco will not be eligible.

Officials say the policy is aimed at improving the health of employees and to get the county’s health insurance costs under control. It’s one of several policies county commissioners approved this week.

The county also is enacting a 50-foot smoking ban from the entrance or exit of any county building on Oct. 1. In two years, no county employee will be allowed to smoke anywhere on county property.

The World Health Organization estimates that cigarettes will bring agonizing early death to 1 billion people around the planet during the 21st century.

The World Health Organization estimates that cigarettes will bring agonizing early death to 1 billion people around the planet during the 21st century.

Two concerned American billionaires who care about humanity teamed up last week to try to save some of the nicotine victims.

New York Mayor Michael Bloomberg joined with retired Microsoft guru Bill Gates in pledging $500 million to halt smoking everywhere. Bloomberg will add $250 million to $125 million he already gave for the crusade. The Bill and Melinda Gates Foundation promised $125 million more. (Both men grew rich from computers: Gates by creating operating systems, Bloomberg by providing online financial data to Wall Street firms.)

Their joint effort will urge all governments to raise tobacco taxes sharply, ban smoking in public places, outlaw advertising to teens and free giveaways of cigarettes, start intensive warnings about tobacco danger, and offer nicotine patches to people trying to quit.

The drive will focus on five heavy-puffing countries: China, India, Indonesia, Russia and Bangladesh. The New York Times commented:

“It promises to be a struggle. Cigarettes are not only highly addictive and supported by huge advertising campaigns, they are also an important source of income for many foreign governments. In some countries, tobacco is a state-owned monopoly, and low- and middle-income countries collect $66 billion a year in tobacco taxes. About 5 percent of countries in the world have any anti-smoking measures like those the campaign envisions.”

That’s dismaying. Such governments are drug-peddlers, just like U.S. cigarette firms, reaping profits from people’s nicotine addiction, ignoring the terrible health toll caused by smoking. The Times noted that “waves of lung cancer deaths … typically begin about 40 years after smoking takes hold in a society.”

In an editorial titled “Stub out that weed forever,” Britain’s Economist said:

“Despite decades of work by health campaigners, more than 1 billion people still smoke today. Smoking kills up to half of those who fail to quit puffing, reducing their lives by an average of 10 to 15 years. The World Health Organization says more than 5 million people a year die early from the effects, direct or indirect, of tobacco.”

NEW YORK (AP) — Microsoft founder Bill Gates and New York Mayor Michael Bloomberg are pooling their piles of money to pour $375 million into a global effort to cut smoking.

The billionaire philanthropists, who have a combined worth of more than $70 billion, said Wednesday that the money will help efforts in developing countries where tobacco use is highest. There are more than 1 billion smokers worldwide.

The $250 million from Bloomberg and $125 million from Gates will support projects that raise tobacco taxes, help smokers quit, ban tobacco advertising and protect nonsmokers from exposure to smoke, their foundations said. It will also aid efforts to track tobacco use and better understand tobacco control strategies.

“Bill and I want to highlight the enormity of this problem and catalyze a global movement of governments and civil society to stop the tobacco epidemic,” Bloomberg said in a statement.

Bloomberg, who built his fortune from the financial information company he founded in the 1980s, is adding to an anti-smoking initiative he funded with $125 million in 2006.

That money goes toward tobacco-fighting campaigns in low- and middle-income countries, most specifically China, India, Indonesia, Russia and Bangladesh. The Bloomberg foundation is also conducting a survey to better understand smoking in those countries.

When Bloomberg first announced that $125 million gift, he said at the time that he believed smoking was a public health issue that was largely ignored by philanthropists. He said he hoped publicizing it would bring more attention from other major foundations.

Gates said Wednesday that $24 million of his gift will go directly toward Bloomberg’s efforts that are already underway.

The remaining money will be used by his foundation to begin its own anti-tobacco work, including preventing tobacco use from increasing in Africa.

“Tobacco-caused diseases have emerged as one of the greatest health challenges facing developing countries,” Gates said in a statement. “The good news is, we know what it takes to save millions of lives, and where efforts exist, they are working.”

Bloomberg, a former smoker who quit about 30 years ago, has crusaded against smoking as mayor. In his first term he banned smoking in bars and restaurants and his health department has an aggressive, ongoing campaign to help New Yorkers kick the habit.

The Liberal Democratic Party (LDP) Research Commission on the Tax System is discussing a major increase in tobacco tax for fiscal 2009 that could raise the price of cigarettes in Japan by 200 yen a pack, despite fierce opposition from the tobacco industry.

The price of a pack is almost certain to go up by at least five yen per cigarette, and a raise of 10 yen per cigarette is also on the table, which would push the price of a 300 yen pack of 20 cigarettes up to 500 yen.

While a price increase to 500 yen would force more people to give up and drive down cigarette sales, central and local government tax revenue is still projected to rise by about 1.5 trillion yen over the approximately 2.2 trillion yen predicted for fiscal 2008. An increase to 1,000 yen per pack has been all but nixed after it was felt that this would significantly decrease tax revenue.

Japan Tobacco and tobacco farmers and retailers have already denounced any tax increases as a devastating blow to the tobacco industry. The LDP is toying with the idea of sugaring the pill for farmers by using some of the extra revenue to pay for subsidies, but debate on the size of the tax increase — unavoidable as far as the commission and the Ministry of Finance are concerned — could last until the end of the year.

Proposed uses for the extra revenue include setting funds aside for an increase in the government’s contributions to basic pensions that is planned for fiscal 2009.

Babies exposed to cigarette smoke before birth or during the first months afterwards run a greater risk of developing asthma and allergy. This according to a doctoral thesis from the Swedish medical university Karolinska Institutet.

It is a well known fact that babies are harmed by tobacco smoke in numerous ways, but it has always been difficult to separate the effects of the mother smoking during pregnancy and passive smoking after birth. Dr Eva Lannerö’s doctoral thesis now provides new detailed knowledge on how exposure to tobacco smoke early in life influences the risk of developing allergy and asthma respectively.

The thesis, which is based on the so called BAMSE study, shows that smoking during pregnancy increases the chances of the child developing asthma. The study showed that children of mothers who had smoked while pregnant ran double the risk of developing asthma before the age of four. There was also a clear correlation between the number of cigarettes smoked and the risk of developing asthma.

Her thesis also shows that passive smoking in early childhood increases the risk of allergy. Four-year olds who were exposed to tobacco smoke when they were two months old had IgE antibodies (allergy antibodies) against one or more allergens in the blood more often than their coevals from non-smoking homes. The strongest correlation was observed for antibodies against cat allergens, which were twice as common in these children.

“This is particularly worrying as cat allergens are almost everywhere and are hard to avoid,” says Dr Lannerö. “We can’t say how many, but some of these children will definitely develop chronic asthma.”

Dr Lannerö’s studies also show that smoking during pregnancy is least common amongst the higher educated. Of the 4,000 interviewed mothers, 7 per cent of those with university-level education said that they had smoked while pregnant, as opposed to 20 per cent of those who had opted out of tertiary or secondary education. The data applies to mothers of children born between 1994 and 1996.

The BAMSE study is a project in which 4,100 Swedish children born between 1994 and 1996 have been monitored from birth in order that scientists can learn more about the impact of different environmental factors on the development of childhood allergy.

More than 65 million mainland teenagers have been affected by second-hand smoke, and about 1 million people die from smoking-related diseases every year, the Ministry of Health said yesterday.

Because of the 350 million smokers in the mainland – one-third of the global total – at least 540 million people have become ill because of second-hand smoke, ministry spokesman Mao Qunan said as part of a promotion for tobacco and smoking control.

“Among the 130 million young people, 15 million are regular smokers, and 40 million others had tried smoking,” Mr Mao said, citing this year’s report. “So far 65 million teenagers have suffered from second-hand smoke.”

He pointed out that more than 100,000 mainlanders had died from second-hand smoke and that smoking-related diseases had killed about 1 million annually.

“Many studies forecast that the death toll of smoking-related diseases would double by 2020 to 2 million people a year, and that the cumulative number would be 100 million by 2050, with half of them dying between 35 and 69.”

He blamed fashionable tobacco advertising, promotion and sponsorship in public places for the increase in the number of young smokers.

With almost 2 trillion cigarettes sold every year, the central government introduced restrictions in 1995 to ban all tobacco advertising.

However, indirect tobacco advertisements and footage of popular idols on TV and movies that imply that smoking is mature and sexy had lured more teenagers to smoke, Mr Mao added.

Chen Weiqing, of Sun Yat-sen University’s School of Public Health in Guangzhou, said the lack of health education in schools and homes was also a key reason young people smoked.

“We found many teenagers had not realised that smoking is harmful because teachers and parents do not pay too much attention to smoking control,” he said. “Indeed, teenagers [find it] very easy to buy cigarettes on the streets due to the lack of prevention and loose restrictions.”

Professor Chen, who studied 3,000 students aged 13 to 15 in Guangzhou from 2005 to last year, said he found only 5.5 per cent of the teenagers continued to smoke after taking part in a three-year experimental workshop on smoking control.

“Many students refused to smoke or go near others who smoke after witnessing the deaths of white mice from smoking in our experimental workshops,” he said. “I suggest that our government introduce a smoking control experimental course … into our educational system.”